The diagnosis and treatment of blunt pancreatic injuries: an analysis of 32 cases

Objective: To explore the diagnosis and treatment of blunt pancreatic injury. Methods: The clinical data of 32 cases with blunt pancreatic injury were retrospectively analyzed from Jan 2005 to Jul 2011. Among 32 cases,17 and 15 cases were diagnosed throngh operation and preoperative examination of B-ultrasonography and multi-layer CT respectively. Five cases with nonoperative treatment,5 cases with the tail of pancreas and spleen resecting, 15 cases with pancreatic debridement drainage,2 cases with duodenal diverticulization,4 cases with pancreatic head end embedding and far end jejunum Roux-en-Y anastomosis and 1 case with pancreaticoduodenal resection were implemented. Results: Thirty cases were cured and the cure rate was 93. 75%. Two cases died and the fatality rate was 6. 25%,which were caused by hemorrhage, infection,multiple organ failure and important organ injury. Three cases with pancreatic leakage were found and two cases cured by conservative treatment and 1 case cured by operating. Two cases of 4 cases with pancreas pseudocyst were self-healing,Its cured by puncturing drainage and operation. Conclusions: The multi-layer CT examination and exploratory laparotomy are the important method for diagnosis of pancreatic injury. The site and degrees of pancreatic injury and pancreatic duct damage are the important basis of treatment and the proper perioperative management can reduce the complications and fatality rate.